AB1387 THE EFFECTS OF PREGNANCY AND FERTILITY ON DRUG USAGE AND PREFERENCES IN RHEUMATOLOGICAL DISEASES: A SINGLE CENTER EXPERIENCE
Authors: B. Karataş, N. Çabuk Çelik, B. Karakaş, İ. Yalçin, G. Pire, H. Ş. Eren, M. Ş. Kuzu, M. Yildirim, B. N. Özdamar, M. F. Aşkin, A. Sahin
Journal: Annals of the Rheumatic Diseases (2022)

Background Rheumatological diseases usually affect women of reproductive age. Although the effects of these diseases on pregnancy vary; Joint and organ damage that may occur should be prevented, maternal and fetal effects of the treatment should be evaluated (1). Objectives The aim of this study to determine the effects of rheumatological diseases and drugs used on pregnancy and fertility. Methods Between January 2014 and January 2021, women between the ages of 18-45 who were diagnosed and treated at Cumhuriyet University Medical Faculty Rheumatology-Internal Medicine Department were retrospectively analyzed. Results The median age of the patients is 37 (min 19-max 45) years. 517 patients (51,7%) were pregnant after diagnosis, 39 patients (3,9%) had abortion after diagnosis, 957 patients (95,7%) had live birth, 69 patients (6,9%) had curettage, 43 patients (4,3%) could not have children. The median of pregnancies before diagnosis is 2 (min 1-max 11) the median of pregnancies after diagnosis is 1 (min 1-max 6) the median of abortions before diagnosis is 2 (min 1-max 7) the median of abortions after diagnosis is 1 (min. 1-max 4) the median of curettage is 1 (min 1-max 3) the median of live births is 2 (min 1-max 5). The distribution of patients according to drug use and drug used during pregnancy is shown in Figure 1. The distribution of the patients according to the diagnosis and the factors affecting pregnancies after diagnosis, abortions after diagnosis, curettage and live birth is shown in Table 1. Table 1. The distribution of the patients according to the diagnosis and the factors affecting pregnancies after diagnosis, abortions after diagnosis, curettage and live birth. †FMF ‡RA ¶AS §PSA Sarcoidosis Granulomatous Mastitis Myositis Vasculitis Behçet’s Disease Still’s Syndrome Gout Fibromyalgia ††SLE Sjögren’s Syndrome Systemic Sclerosis ‡‡APS Avaliable (%n) 224 %22.4 197 %19.7 274 %27,4 59 %5,9 1 %0,1 1 1 7 %0,7 169 %16,9 3 %0,3 2 146 %14,6 105 %10,5 60 37 %3,7 29 %2,9 %0,1 %0,1 %0,2 %6 Not Avaliable (%n) 776 803 %80,3 726 %72,6 941 %94,1 999 %99,9 999 %99,9 999 %99,9 993 %99,3 831 %83,1 997 %99,7 998 %99,8 854 %99,9 895 %89,5 940 %94 963 %96,3 971 %97,1 %77,6 Total (%n) 1000 %100 1000 %100 1000 %100 1000 %100 1000 %100 1000 %100 1000 %100 1000 %100 1000 %100 1000 %100 1000 %100 1000 %100 1000 %100 1000 %100 1000 %100 1000 %100 Use of colchicine Use of anakinra Use of methorexate Use of leflunomide (*OR %95 confidence range) (*OR %95 confidence range) (*OR %95 confidence range) (*OR %95 confidence range) **p value **p value **p value **p value Number of pregnancy after diagnosis *OR:1,58 (1,22-2,034) *OR:6,69 (1,51-29,60) *OR: - 0,73 (0,51-0,93) *OR: - 0,53 (0,30-0,93) **p: ‹0,001 **p: ‹0,004 **p: 0,05 **p: 0,035 ‡‡APS (*OR %95 confidence range) ††SLE (*OR %95 confidence range) **p value **p value Number of abortion *OR: 3,7 (1,68-8,43) *OR: 7,5 (2,78-20,25) after diagnosis **p: ‹0,001 **p: 0,001 ‡‡APS (*OR %95 confidence range) **p value Number of curettage *OR: 5,5 (1,94-15,84) **p: 0,001 Number of live birth *OR: - 0,20 (0,05-0,75) **p: 0,017 *OR: Odds Ratio **p‹0,05 significant †FMF: Family Mediterranean Fever ‡RA: Rheumatoid Arthritis ¶AS: Ankylosing Spondylitis §PSA: Psoriatic Arthritis ††SLE: Systemic Lupus Erythematosus ‡‡APS: Anti Phospholipid Syndrome Figure 1. Distribution of patients according to drug use and drugs used during pregnancy Conclusion Women with rheumatic diseases should be in remission before pregnancy and should be followed closely throughout their pregnancy and treated with pregnancy-safe drugs. Preparations that can cause infertility in women during the reproductive period should not be used as much as possible. Patients should be informed in detail about the effects of their disease and the drugs used on pregnancy. References [1]Peterson E. A., Lynton J., Bernard A., Santillan M. K., Bettendorf B., Rheumatologic Medication Use During Pregnancy, Obstetrics &amp; Gynecology: May 2020 - Volume 135 - Issue 5 - p 1161-1176doi: 10.1097/AOG.0000000000003755. Acknowledgements We would like to thank to Biostatistics Faculty Member Dr. Ziynet Çinar. Disclosure of Interests None declared